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首页> 外文期刊>Journal of cardiac surgery. >Surgery for left ventricular aneurysm: is there still any role for simple linear repair?
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Surgery for left ventricular aneurysm: is there still any role for simple linear repair?

机译：左心室动脉瘤手术：简单的线性修复还有什么作用？

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The aim of left ventricular aneurysm (LVA) surgery is to eliminate the diskinetic portion of the left ventricle and to restore the patient's clinical condition. This can be obtained with two surgical procedures: linear repair and endoventricular patch technique. We investigated early- and long-term results in patients who underwent both procedures. From January 1980 to December 2004, 158 patients underwent surgical repair of LVA: 86 had linear repair and 72 patch repair. Operative mortality was 6.9%, with no differences between the two groups. Logistic regression revealed older age, higher left ventricular end-diastolic volume, and an ejection fraction (EF) less than 30% as independent risk factors for in-hospital mortality; the type of operation "per se" did not influence the early mortality. At the follow-up extending up to 25 years, there was no statistically significant difference in survival between the two study groups, as well as in New York Heart Association and Canadian Cardiovascular Society classes. Cox regression revealed older age, EF less than 30%, urgent operation, and a history of cerebrovascular accident as independent risk factors for late mortality: the type of operation did not influence mortality at follow-up. We conclude that aneurysm resection associated with myocardial revascularization is the best treatment for LVA. The choice of the technique should be tailored on an individual basis, according to aneurism location, extension, residual ventricular function, and septal involvement.
机译：左心室动脉瘤（LVA）手术的目的是消除左心室的椎间盘突出部分并恢复患者的临床状况。这可以通过两种外科手术程序获得：线性修复和脑室修补技术。我们调查了接受这两种程序的患者的早期和长期结果。从1980年1月至2004年12月，有158例患者接受了LVA的手术修复：其中86例接受了线性修复，而72例进行了修补。手术死亡率为6.9％，两组之间无差异。 Logistic回归显示年龄较大，左心室舒张末期容积增加和射血分数（EF）低于30％是医院内死亡的独立危险因素; “本身”手术的类型并不影响早期死亡率。在长达25年的随访中，两个研究组之间以及纽约心脏协会和加拿大心血管学会课程的存活率在统计学上均无统计学差异。 Cox回归显示年龄较大，EF低于30％，紧急手术和脑血管意外史是晚期死亡的独立危险因素：手术类型不影响随访时的死亡率。我们得出结论，与心肌血运重建相关的动脉瘤切除术是LVA的最佳治疗方法。技术的选择应根据动脉瘤的位置，范围，残余心室功能和中隔的介入情况，根据个人情况进行调整。

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